Hospital Nurses Burn Out on Long Shifts

Hospital nurses working shifts of 13 or more hours suffered from higher levels of burnout, patient dissatisfaction, and safety issues, according to a new study.

Researchers at the University of Pennsylvania School of Nursing (Philadelphia, USA) analyzed data from 22,275 nurses participating in the Multi-State Nursing Care and Patient Study, who worked at 577 hospitals in four US states; the analysis was restricted to nurses on medical or surgical units and in the intensive care unit (ICU). To estimate patient satisfaction, the researchers pooled data from the Hospital Consumer Assessment of Healthcare Providers and Systems survey, conducted during 2006 and 2007, at the time the nurses' survey was conducted.

The results showed that more than 80% of the nurses were satisfied with scheduling practices at their hospital. However, as the proportion of hospital nurses working shifts of more than thirteen hours increased, patients' dissatisfaction with care increased. Furthermore, nurses working shifts of ten hours or longer were up to two and a half times more likely than nurses working shorter shifts to experience burnout and job dissatisfaction and to intend to leave the job. The study was published in the November 2012 issue of Health Affairs.

“We found that seven of the 10 outcomes were significantly and adversely affected by the proportion of nurses in the hospital working shifts of more than 13 hours,” said lead author Amy Witkoski Stimpfel, PhD, RN. “Nurses underestimate the impact of working long shifts because the idea of working three days a week instead of five seems appealing.”

“Extended shifts undermine nurses' well-being, may result in expensive job turnover, and can negatively affect patient care,” concluded Dr. Stimpfel and colleagues. “Policies regulating work hours for nurses, similar to those set for resident physicians, may be warranted. Nursing leaders should also encourage workplace cultures that respect nurses' days off and vacation time, promote nurses' prompt departure at the end of a shift, and allow nurses to refuse to work overtime without retribution.”

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University of Pennsylvania School of Nursing